Shopping for family orindividual coveragecan be intimidating. From where to get coverage to what you need to provide, you likely have a lot of questions.
Whether you need to apply for health insurance for the first time, or you need to change insurance plans, understanding the health insurance application process is important. Having an idea of what you need to do and what to expect—like how long it will take before your coverage starts—can help you better prepare.
Keep reading to learn more about how to get started and get an overview of the four main steps for applying for health insurance.
Watch this video to understand the basics of enrolling in health insurance, and read on to get a step-by-step outline.
When Can You Apply for Health Insurance?
If you want to apply for medical insurance, you may be restricted by certain dates. For example, if you want to purchase health insurance on the ACA marketplace, you can only do so during the open enrollment period. For 2025, the health insurance stop location open enrollment period runs from November 1, 2024 to January 15, 2025. There is also a chance that you couldqualify for a special enrollment periodif you meet certain conditions.
You may also want to check with your state to see if they are starting their open enrollment period earlier. If so, you may have a bit more flexibility. It varies from state-to-state, and it may depend on your specific circ*mstances. Therefore, you should reach out to a professional who can help you.
If you are getting health insurance through your employer, they usually have their own dates for when the enrollment period is open. If you are starting a new job, you should be given the opportunity to apply for health insurance regardless of the calendar. On the other hand, if you want to change the health insurance plan you have through your employer, you may be restricted to certain dates.
After you sign up for a health insurance plan, there is a chance that you may need to wait for a few days, weeks, or months before you can take advantage of certain benefits. You should clarify this with your health insurance provider so that you have a good understanding of timing as well as what is covered and what is not.
Here are four simple steps that outline the process of buying a health insurance plan in some cases. We all know that life isn’t so simple, and the step-by-step process doesn’t look the same for everyone, but this outlines the general process of what buying insurance can look like. Keep in mind that these steps can vary by state, product, and time of year you are shopping.
Step 1: Shop and Estimate
Anyone can enroll in coverage for themselves or their family during the nationwide open enrollment period. However, if you are shopping outside of open enrollment, you may only be able to purchase a major medical plan if you have aqualifying life event.
Qualifying life events include things like marriage or divorce, the birth or adoption of a child, moving to a new coverage area, or the loss of other forms of qualifying coverage – like employer-based coverage.
If your qualifying life event is loss of employment (and you lost your coverage under their group plan) then you can use eHealth as a resource to find coverage.
What if I’m told I need Medicaid?
If a website or agent suggests you are eligible for Medicaid, keep in mind that your eligibility may change if your income changes. If you don’t want to enroll in Medicaid, you are not required to.
You can shop for individual and family plans as well as supplemental health insurance products oneHealth.com. If you qualify for government subsidies, eHealth can help you apply for them in most cases.
If you missed the open enrollment deadline and have not experience a qualifying life event, then you can search for alternative products such as short-term health insurance, medical insurance packages, or other supplemental insurance products like accident or critical illness insurance.
Medical Insurance Packages
Many people create their own personal insurance package by purchasing a combination of these products. Read more about pre-determined medical insurance packages.
Step 2: Apply and Enroll
Once you’ve found the plan that’s right for you and your family, you can complete the application to enroll. Review your results and enrollment details before submitting your final enrollment. You may find it helpful to keep family dates of birth and other information handy when completing your enrollment forms.
Step 3: Make your First Payment
Once your application for health coverage has been submitted, you’ll need to make your first payment before your coverage can begin.
If you are buying an alternative or supplemental health insurance product, make sure you understand how the payments work. The process varies for different products. Also, understand that certain non-insurance products are different from an ACA qualifying plan or a Major Medical plan—they are not actual insurance and are only meant as a supplement or short-term solution.
In most cases, you will be prompted to enter your credit card information for your first payment, and that information will be passed by eHealth to the insurance company. If your insurance company is not set up to take online payments, eHealth will email you the information you need to make your first payment.
Step 4: Cards and Coverage
Once you’ve enrolled and made your first payment it can take about 3 weeks, for your application to be processed. If you applied for major medical health insurance and your enrollment was received in the first fifteen days of the month, your coverage will typically begin on the first day of the following month.
The Date of Application Impacts Enrollment Dates
If your application and payment for a major medical (Obamacare plan) is received on the 16thday of the month or later, your coverage will generally begin on the first day of the month after next.
You will receive your insurance cards and a welcome package in the mail along with a copy of your insurance policy after you’ve been approved.
Enrollment Dates for Flexible Products (Short-Term Medical, Medical Insurance Packages)
For these flexible insurance products, which are designed to function as temporary coverage between enrolling in comprehensive plans, enrollment dates may vary, based on the insurance company and the date in which you apply.
In many instances, enrollment and coverage can begin within 10 days or less of your first payment, however they are limited to only 3 months of coverage with an option to renew for one additional month.
Do You Need to Apply for Health Insurance Every Year?
You don’t necessarily need to apply for health insurance every year. If you want to keep the same health insurance plan, it should automatically renew. Regardless of whether you have a plan through your employer, or if you have signed up to get your own plan through the health insurance marketplace, your plan should automatically renew.
On the other hand, if you want to change your health insurance plan, you will need to reapply. Regardless of whether you are looking to save money or change your coverage, you might need to reapply if you want to change your health insurance plan.
How Much Will It Cost to Sign Up for Insurance?
Health insurance plans will come with a premium; however, the premium varies depending on the type of coverage you have, your location, and whether you are getting insurance through your employer.
If you get insurance through your employer, you may be able to save money on the cost of your health insurance premium. Usually, they’ll pay a portion of your monthly premium and the rest of it comes out of your paycheck.
There may be some additional fees that you have to pay when you get health insurance. For example, there may be an application fee, or there may be a different one-time fee that the company charges. These fees can vary significantly depending on the type of plan you have, so you should clarify them before you sign up for a plan.
Can I get Health Insurance Without a Job?
It is certainly possible for you to get health insurance even if you don’t have a job. You just won’t be splitting costs with an employer and you’ll have to adhere to the Open Enrollment Period, which is typically from November 1st through January 15th. However, you may be able to qualify for the Special Enrollment Period.
You can take a look atindividual or family health insurance planson the ACA marketplace to determine which one is best for your needs. Typically, the plans on the marketplace fall into one of the“metallic” tiers. You can try to find a plan that offers minimum essential coverage (MEC). That way, you have solid health insurance protection, while keeping your costs as low as possible.
Note that individuals 65 or older may also be able to qualify forMedicare.
Sign Up for Affordable Health Insurance
Some people are concerned that health insurance is expensive. Fortunately, there are affordable health insurance policies out there. At eHealth, we can help you find and compare insurance policies so you can sign up for coverage you can afford.
Our licensed insurance agents can also answer any of your questions, help you navigate the process, and assist you inapplying for Medicareor other health insurance plans. Get started today to make sure you’re covered.
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